Some CME experts remain skeptical when it comes to social media

Physicians are on Facebook. Many tweet and communicate via Snapchat. They'd no sooner give up their smartphones than the rest of us would. But when it comes to satisfying CME requirements via social media, they expressed minimal interest, at least in part because there wasn't much in the way of viable and trustworthy options.

That changed late in 2016 when Physician's Weekly, which provides continuing medical education services to physicians, launched its first CME course using Facebook Live. The publishing company worked with continuing-education provider Advancing Knowledge in Healthcare (AKH) and Dr. Zubin Damania to launch its first accredited CME Facebook live-cast. The event, targeted at physicians and nurses, took place on December 12, a Monday evening at the start of a workweek.

Damania, also known as ZDoggMD, a physician personality and creator of music video parodies with lyrics rewritten to focus on health, presented a 39-minute interactive CME course for physicians and nurses on better understanding patients' decision-making processes.

The course touched on charged issues such as end-of-life care, highlighting insights from Jonathan Haidt's book The Righteous Mind: Why Good People Are Divided by Politics and Religion. During the session, participants posted comments and received replies from Damania.

“Having it live, where ZDoggMD could interact with participants, added an element of excitement,” explains Ezra Ernst, CEO of Physician's Weekly. “If you create excitement for students, they're more likely to learn.”

Damania's Facebook Live course garnered more than 34,000 views and 600 comments during the live session — and those numbers are expected to grow with the video remaining on his Facebook page and the Physician's Weekly website for a year. As of late January, 369 people have received CME credits for watching the course and completing an evaluation, which required them to answer questions on material discussed during the livecast.

Ernst says planning the course was tricky, in no small part because the companies decided to partner with Damania, who tends to go off script. But they decided his personality and influence in the social realm — he has close to 400,000 followers on Facebook — were valuable.

SPEED, COST, and ACCESSIBILITY

What makes social media an attractive CME tool is its accessibility and low cost, not to mention the speed with which it prompts immediate interaction, notes Brian McGowan, cofounder and chief learning officer of ArcheMedX, a healthcare e-learning company. Michael Leis, SVP, social strategy at Digitas Health LifeBrands, agrees, noting the excitement that comes with creating a live community.

At the same time, CME experts remain somewhat skeptical, not merely about the Facebook Live CME course, but about the value and effectiveness of social media-driven CME in the bigger picture.

“If I'm an accredited provider, I could go onto Facebook and run a one-hour educational program on the repeal of Obamacare, and the course could be up and live within minutes. I love that,” McGowan notes. “But you can't lose sight of the fact there's no evidence that it's really effective.”

Despite 369 people receiving credit for Damania's course, there is no evidence it had any impact on the practice behavior of physicians and nurses.

“Whatever technology you're using, how do you get the benefit of it, but not lose the central DNA of what it means to be a good educator?” McGowan asks. “What are the interventions? What's the evidence based on the intervention?”

CME giant Lewis Miller, founder of the Alliance for Continuing Education in the Health Professions, the Global Alliance for Medical Education, and consulting firm WentzMiller Global Services, agrees, adding, “There are models of online CME that have been successful. But the risk-reward ratio remains, as does the lack of measurement of the effectiveness of it. This, for the most part, fails to include the characteristics of most effective CME — interaction, reflection, and repetition.”

On top of that are issues surrounding privacy and legitimacy. According to McGowan's research, very few physicians use social media for professional purposes. In 2012, he found that 6% of doctors use Twitter professionally; 36% said they would not use the social platform at all for professional purposes. Similarly, his research revealed that only 24% of physicians used Facebook professionally.

In fact, doctors are taking courses to learn how to anonymize their personal profiles so patients can't find them.

“It's becoming more of a routine in medical schools and hospital networks in which there's sensitivity about how they use open social media platforms,” Leis notes. “What happens if they click the ‘like' or ‘laughing' button? What does that mean? Doctors don't have the ability to control the context within which the communication is happening.”

FIGHTING FAKE NEWS

Additionally, Miller explains that within social media it is often difficult to decipher the authenticity of a given item, especially given the rise of fake news.

“With Twitter, I find myself increasingly worried that novel ideas of diagnosis and treatment may be introduced in a manner that influences physicians and other healthcare providers to be early adopters of inappropriate and perhaps dangerous untested ideas,” he says. “These may not be presented as accredited CME, but their deleterious effect may carry over.”

Still, the skeptics don't entirely rule out social media as a host venue for impactful CME programming. McGowan — who founded a company around providing online CME — believes any such platform must allow physicians to be “super learners,” which would require features such as note-taking and the setting of reminders.

“What if you were to take that same video of ZDoggMD and put it into an environment where physicians can take notes and set reminders?” McGowan asks. “We have data about learners who went through a CME experience that allowed them to take notes and set reminders, and it had all these nudges built into it. Not only did three times as many people complete the activity, but they learned four to six times more than those who went through the traditional online experience with the same video files.”

Leis sees potential in physician social media sites such as Sermo and Doximity, which could prove adept in leveraging live video capabilities for CME training.

“Maybe this course is going to be for 10 minutes over the span of the week, and if you miss one, you can catch up with the recorded stuff,” Leis speculates. “There's something to that live broadcast experience, and even more to that live interactive experience. Everyone's looking for what's going to be the right application of instant video now that we have the software and infrastructure capability to make it doable.”

The Facebook Live course was the first in a series of CME initiatives Physician's Weekly has planned. The company will continue working with AKH and Damania to develop more CME livecasts, including the launch of live tweet chats. The organizations are also considering adding Snapchat to their slate, Ernst adds.

“There's a trend element to Twitter that is different from Facebook and is very valuable,” he explains. “And Snapchat is a much more visual medium. Maybe we'll show procedures or demonstrations.”